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patients with IDDM often show low insulin-like growth factor(IGF-) I and low IGF binding protein (BP)-3, acutely increased IGFBP-1 may bind to free IGF-I, resulting in further decreased bioavailability of the latter in the circulation. Then the decreased amount of free IGF-I may cause hyperglycemia because of a decreased hypoglycemic effect, and it may also result in increasing GH secretion as a negative feed-back. The acute increase in IGFBP-1 can account for a low hepatic insulin level early in the morning in patients with IDDM dependent on administered exogenous insulin, since IGFBP-1

Role of Insulin-Like Growth Factors and Related Binding Proteins in Glycemic Control in Children and Adolescents with IDDM